TCT-490 Coronary Artery Disease and Tako-tsubo Cardiomyopathy: a Possible Association

Abstract

Guido Parodi, Rodolfo Citro, Benedetta Bellandi, Eduardo Bossone, Stefano Del Pace, Marco Marrani, Fausto Rigo, Francesco Bovenzi, Renato Valenti, David Antoniucci Careggi Hospital, Florence, Italy, San Giovanni di Dio e Ruggi d’Aragona, Salerno, Salerno, Ospedale dell’Angelo, Mestre, Mestre, Ospedale campo di Marte, Lucca, Lucca Background: In the medical literature several cases of Tako-tsubo cardiomyopathy (TTC) with critical coronary artery disease (CAD) has been reported, and in the clinical practice several typical TTC cases shown significant stenosis of coronary arteries that cannot be related to the dysfunctional myocardium. The aim of this study is to evaluate the prevalence, clinical characteristics and outcome of patients with TTC and critical CAD in a large multicentre database. Methods: In the 26 participating centers, 450 patients admitted with the diagnosis of TTC (modified Mayo Criteria) underwent coronary angiography within 48 hours of hospital admission and were progressively included in the Tako-tsubo Italian Network (TIN) Registry. Results: Overall, 43 (9.6%) patients had at least 1 critical coronary stenosis ( 50%) not supplying the dysfunctional myocardium, or a previous myocardial revascularization (percutaneous or surgical), while 407 (90.4%) had not critical stenosis or truly normal coronary arteries. TTC patients with critical CAD were more likely to have advanced age, diabetes, familiar history of CAD, acute functional mitral regurgitation and a delayed left ventricular function recovery as compared with those without. At 6-month follow-up, the incidence of death, TTC recurrence and rehospitalization rates were similar between patients with critical CAD and patients with normal coronary arteries (Table). At multivariable Cox analysis, independent predictors of death were Charlson comorbidity index while the presence of CAD did not significantly influence mid-term outcome.